The overall objectives of this research effort are to develop and test methods for assessing care needs of long-term patients and evaluating the appropriate response to these needs in terms of resources and manpower. Within this general framework, more specific goals are to: a) document and evaluate the process and outcome of patient care in long-term care facilities and programs; b) indicate resource requirements for long-term care facilities and programs; c) develop sets of guidelines for review of long-term care services provided; d) forecast regional resources and manpower skill mixes; and e) conduct comparisons of alternative care settings and processes in terms of adequacy and cost. Initial efforts for the first two years of the project concentrate on the development of instruments and procedures for assessing long-term patient care needs and formulating appropriate care plans. Data related to care activities, patient mix, staffing patterns, and facilities (or programs) organizational structure will provide the basis for review of extent and quality of services rendered. It is anticipated that the procedures to be developed for assessing patients and for formulating care plans can be implemented in selected pilot sites and evaluated in terms of actual care delivered and its appropriateness. Ultimately the research effort should lead to a better understanding of the kinds of organizations and programs that must be structured to meet the needs of a comprehensive long-term delivery system, and will produce standards for review of care activities and their effect on patient outcome.